As greater numbers of baby boomers have transitioned to retirement and begun to anticipate and experience the decline in vitality and health associated with the aging process, increasing consideration has been given to issues relating to the end of life years. Some of this attention has focused on the means of caring for those who have simply become infirm, or have become an invalid as a result of illness. This attention has in part also been due to media exposure surrounding public officials and celebrities who have permitted disclosure of such information, including those who are handicapped and no longer ambulatory as a result of disease or accidents.
The major care-giving issues typically include general and oral hygiene, basic physical exercise to prevent atrophy or even a full physical therapy program if appropriate, proper feeding to satisfy nutritional requirements of the injured or elderly, administering medications in a timely fashion, and assisting with elimination of urinary and fecal waste. The latter issue has seen many different approaches aimed at easing the difficulty of the task, where inadequacy in care may contribute to urinary and fecal incontinence, which has become prevalent in nursing home patients.
The difficulty of the task is directly related to the mobility and independence of the person involved. When a person maintains a sufficient amount of vigor, and of course is not a quadriplegic, they may contribute significantly in transporting themselves to use a standard toilet, perhaps requiring little or no assistance. As the individual grows increasingly infirm, such movement to and from a standard toilet will increasingly depend upon assistance by a caregiver, but may ultimately be limited depending on the size of the person needing assistance and the strength and agility of the caregiver.
The simple and immediate solution to that size/strength disparity, or to the reduced vigor of the user, is to provide a replacement for the standard lavatory toilet with some sort of a portable commode that may be located in close proximity to the user. This solution has seen the development of a variety of different commodes and/or bed pans.
One such solution is the stand-alone commode, as illustrated by U.S. Pat. No. 5,123,126 to Vincent. The patent discloses a modest-sized toilet seat over a bedpan that is mounted onto a walker frame with handrails, so that the user may independently make use of the rails to transport himself or herself to and from a bed to use the commode. The commode of U.S. Pat. No. 5,197,152 to Rose offers a comparable solution, but would appear to sacrifice the utility of the forward entry and hand rails of Vincent, for the greater comfort of a more conventional seat, which also inconveniently requires a posterior entry position—an entry position that would necessitate an unstable user having to rotate 180 degrees.
Both the invention of U.S. Pat. No. 5,123,126 and of U.S. Pat. No. 5,197,152 may successfully limit the distance that must be traveled by the infirm to the area immediately adjacent their bed, wheelchair, or other place of recuperation. However, this would only be available to those who still possess some ability to egress and ingress from their normal resting place. The traditional hospital or hospice approach has involved the use of small, portable, hand-held bed pans. While such portable bedpans have seen extensive use, both the portable and stand-alone bed pans or commodes mandate some level of assistance being provided by the care-giver, which is also a limitation upon the user as to when elimination may occur.
A greater level of independence from the assistance of the caregiver has been found with use of inventions such as that shown by U.S. Pat. No. 5,577,753 to Pociask. The Pociask invention relates to a wheelchair whose specially designed frame and wheels permits it to back up to and over a toilet, where the elongated seat has an opening that would be in-line vertically with the toilet bowl. The occupant may slide forward in the wheelchair seat over the seat opening to independently accommodate toilet needs. This approach provides increased freedom to those who are confined to a wheel chair throughout much of a day, while seeking to make use of conventional toilet facilities.
However, the Pociask approach still has several drawbacks. First, it is inherently a solution which is only available to those users who have the ability to use a wheel chair, and further still, for those who have been assisted into their wheelchair on a given day, as the solution requires access to a standard toilet. The requirement of access to a standard toilet in itself poses several problems or limitations. Where a toilet has a non-standard shape or installation, the Pociask wheelchair may not properly overlay about the toilet envelope. Moreover, where a wheelchair occupant resides at a place that has a conventional bathroom arrangement with sink, toilet and tub, there may be insufficient room to accommodate the increased wheel base of the wheelchair necessary to straddle the toilet, due to interference from the sink cabinet or tub periphery.
Another weakness of the Pociask approach is that it mandates that the user in his wheelchair remains in close proximity to the toilet facility. Many elderly, ill, and handicapped persons have little control over such bodily functions, so in order to be effective, they must not necessarily travel to distant areas of a nursing home or hospital, or even perhaps to a different floor of their residence, which may not have ready access to a toilet. As such, the Pociask invention does nothing to liberate the user from his hospital or convalescent room.
For those individuals who are far less mobile, the Vincent, the Rose, or even the Pociask inventions may still be utilized by transporting the incapacitated user to the commode or wheelchair through the use of a medical sling. While some insurance policies and even Medicare provide for the use of such devices, using a medical sling to lift an invalid from a bed or couch to a commode or the wheelchair of Pociask, still requires substantial caregiver assistance, and further aggravates the issue of timing due to the needs of the user.
The invention disclosed herein addresses all of these problems associated with the prior art, by providing a solution which is diverse in its applicability, such that it may be incorporated into an ordinary arm chair or couch, a bed, a wheel chair, or any other means occupied during convalescence or during an extended or permanent period of disability.